What is it about?

Adolescents are migrating alone from the Central America to the United States to escape pervasive violence, and most have experienced violence, threats, and witnessing the deaths of family members and friends in their home countries. School-based mental health services can provide easy access to treatment, including groups using trauma-focused therapy approaches. We evaluated the safety and acceptability of a 10-week group intervention, Cognitive Behavioral Therapy for Trauma in Schools (CBITS) for Central American unaccompanied immigrant youth by interviewing immigrant youth, CBITS group leaders and other adults working with youth in schools. Newcomers from Central America were reluctant to disclose their story in the group, fearing for family members’ and their safety, but found that group support, learning coping skills and feeling less isolated were helpful.

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Why is it important?

Over 300,000 Central American teenagers have arrived in the US since 2014, many of them coming alone, with significant trauma histories. Many of these immigrant youth speak indigenous languages and have little prior exposure to mental health care. We assessed a popular manualized group intervention used in a Northern California community that encourages disclosure of significant trauma as well as developing coping skills, by interviewing youth and adults who worked with them in English, Spanish and Mam (a Mayan language prominent in the community), including Mam interpreters. We were able to elicit cultural and historical reasons for the reluctance of Central American immigrant youth in this community to disclose their trauma histories, the importance to them of social connection and developing coping skills, and successful ad hoc modifications made by therapy group leaders.


I have worked with immigrants and refugees from Mexico and Central America for most of my career as a nurse clinician and researcher, and come from an immigrant family myself. It was a pleasure to collaborate in writint this article with other clinicians and researchers from a local community clinic that serves an immigrant population, and research associates whose own Latinx immigrant backgrounds increased the trust of participants and added important perspectives to the work

Naomi Schapiro
University of California, San Francisco

Read the Original

This page is a summary of: When silence feels safer: Challenges and successes of delivering a school-based cognitive behavioral intervention to Central American unaccompanied immigrant youth., Psychological Trauma Theory Research Practice and Policy, December 2022, American Psychological Association (APA),
DOI: 10.1037/tra0001414.
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